Chaptre 2. Facility Layout Introduction Product layout Process layout Fixed position layout

1. Chaptre 2. Facility Layout • Introduction • Product layout • Process layout • Fixed position layout • Facility layout supplement

2. Introduction Facility layout design is necessary when building a new facility or renovating an existing one in order to improve process flow and minimize waste space. Facility layout largely depends on the shape and size of the building.

3. Facility layout is important The overall layout of a facility will last for long time and only minor changes are possible after the building or renovation. Layout has enormous effect on daily operations. Layout dictate the distance a patient or staff member travels Layout influences the interations and communications of the staff members.

4. Goals of Facility layout • Functionality: • Placing heavily interated departments together • Placing apart departments that should not be close • Ensuring space and form requirements • Facilitating communication • Cost savings: • Reduction of travel times • Reduce overall space requirement • Enabling for reduced staffing by placing similar job functions together

5. Three basic types of Facility layout Product Layout Process Layout Fixed position layout Can be used to either a single department or an entire facility. But also: Retail store layout Warehousing and storage layout (relation of unloading and loading areas)

6. Types of manufacturing systems • Job-Shop production • Process layout, functionally similar machines are grouped • Flow-shop production • Product layout, machines are arranged along the manufacturing processes of a product • Celluaire manufacturing systems • Hybrid layout, similar parts and corresponding machines are grouped • Project shop • Product is fixed, personnel and equipment brought to it • Continuous-flow process • Chemical plants and flood industry

7. Organisation dans les hôpitaux • Principalement une organisation fonctionnelle en unités de soins, plateaux techniques auxquels on associés tous les ressources humaines/matérielles de chaque fonction • un patient passe d’une unité à l’autre en fonction des soins nécessaires • mais aussi des ressources humaines/matérielles mutualisées, et des ressources humaines détachées à d’autres unités, ...

8. Layout of an emergency department Surgery E.R. triage room Emergency room admissions Patient A Patient B Laboratories Radiology E.R. beds Pharmacy Billing/exit Patient A (broken leg) proceeds to ER triage, radiology, surgery, bed, pharmacy, billing. Patient B (pacemaker rpoblem): ER triage, surgery, pharmacy, lab, bed, billing.

9. Chaptre 2. Facility Layout • Introduction • Product layout • Process layout • Fixed position layout

10. Product Layout The product layout arranges equipment (departments) in the order of production process flow. Generally used in mass production such as automobile assembly where the processes are standardized and there is little variation. Product layout is generally less flexible and requires higher initial equipment costs. But it minimizes the process cycle time and increases equipment utilisation. Examples: hospital cafeteria, standardized biological tests.

11. Product Layout • Product layout, known as assembly line balancing problem, is generally determined by the product or service itself. • Most decisions concern • assignment of basic operations to different workstations • in order to balance the workloads • such that each station has approximately the same cycle time, i.e. the time for one item to pass through that workstation (Why) • Two types of problems: • Using a minimum number of workstations to achieve a given cycle time • Minimizing the cycle time given the nb of workstations

12. Product Layout An example of 3 stations and cycle time 70. Waste time = ?, workstation cycle time = ?

13. Product layout • Since variability is inherent in health care, the product layout is rarely used in health care other than for supporting activities • Although the health care process is similar for a patient group with similar diagnosis, the amount of time that patients spend in each process varies greatly. Line balancing is impossible.

14. Chaptre 2. Facility Layout • Introduction • Product layout • Process layout • Fixed position layout

15. Process layout The process layout, known as layout by functionality, groups different types of process (departments, equipments) together to provide the maximum flexibility. Hospital groups together functions such as intensive care, surgery, emergency medecine, and radiology as separate departments The flexibility allows accomodate the variability of patient flows and times while preserving high utilisation of resources The downside of a process layout is the large travel time, and high material handling costs. A good layout will reduce this negative impact.

16. Closeness-based method Identify the desireness and undesireness of closeness by closeness rating chart. Codes for desired closeness: A – absolute necessary E – very important I – important O – ordinary important U – unimportant X – undesirable.

17. Closeness-based method Closeness rating charting area in m Department 1. Nurses’ station 40*80 A A 2. Ambulance entrance 40*40 O I E U 3. Patient Room Area remaining E X I E U 40*80 4. Laundry X I U 80*80 5. Main entrance X 40*80 6. Dietary Department

18. Closeness-based method Using a heuristic rule to design layout. Step 1. Assign departments to available spaces according desired closeness relationships identified as absolutely necessary or undesirable, i.e. A and X, by starting with the most frequent department in either relationship. A graph representation of A and X closeness can be built. Step 2. Consider other departments with relationships E, I, O, U.

19. Closeness-based method A and X closeness representation Ambulance entrance A Nurses’ Station A Patient room area Laundry X Main entrance X X Dietary Department

20. Closeness-based method A and X closeness representation 2 Ambulance entrance A 1 Nurses’ Station A 3 Patient room area 4 Laundry X 5 Main entrance X X 6 Dietary Department

21. Closeness-based method Final layout 4. Laundry 3. Patient Room area 200 m Amb. entrance 1 nurses’ station 5. main entrance 6. Dietary Dept. 400 m

22. Distance and cost-based method This method tries to minimize the costs or repetitive distances traveled by patients and staff. Data representing such traffic are represented in a from-to chart which represents the nb of trips or flows between departments. Once the traffic information is identified, departments with most frequent traffics are assigned to adjacent locations. Informations such as department space requirement, fixed locations, ... can be taken into account. The problem is highly combinatorial when the nb of department is large and software tools such as CRAFT are necessary.

23. Distance and cost-based method Formall, the objective is to Minimize total cost TC = ij Dij Wij Cij where W =[Wij] is the From-To traffic matrix D =[Dij] is the distance matrix (Manhattan distance or Euclidean distance, why) C =[Cij] is the unit traffic cost

24. Distance and cost-based method Example: Consider a small hospital of 3 departments A, B, C. Three locations 1, 2, 3 of identical size are available. Assume that a nurse can walk 100 feet in 30 seconds and earn $48 per hour. Unit traffic cost Cij = 0.004$ / foot walk 100 feet 100 feet location 1 location 2 location 3

25. Distance matrix (in feet) Location From/To 1 2 3 1 - 100 200 2 100 - 100 3 200 100 - Condensed traffic matrix Department From/To A B C A - 3300 1400 B - 200 C - Traffic matrix (in trips) Department From/To A B C A - 1000 300 B 2300 - 100 C 1100 100 - Distance and cost-based method

26. Distance and cost-based method Dept. B Dept. A Dept. C

27. Distance and cost-based method : example 2 The Walters Company’s management wants to arrange the 6 departments of its hospital in a way that will minimise interdepartmental material handling costs. They make an initial assumption (to simplify the problem) that each department is 20x20 feet and that the building is 60 feet long and 40 feet wide. The process layout procedure that they follow involves 6 steps.

28. Distance and cost-based method : example 2 Step 1. Construct a « from-to-matrix » showing the flow of patients or personnals from department to department.

29. Distance and cost-based method : example 2 Step 2. Determine the space requirements of each department. room1 room2 room3 Department 1 Department 2 Department 3 Department 4 Department 5 Department 6 room4 room5 room6 Building dimensions and a possible department layout

30. Distance and cost-based method : example 2 Step 3. Develop an intial schematic diagram showing the sequence of departments through which patients will have to move. Try to place departments of heavy flow next to one antoher. 100 3 1 50 2 30 20 10 20 100 50 5 4 6 50

31. Distance and cost-based method : example 2 Step 4. Determine the cost of this layout with traffic cost of 1€ between adjacent departments and 2€ between non adjacent departments. Cost = 570 €. 100 3 1 50 2 30 20 10 20 100 50 5 4 6 50

32. Distance and cost-based method : example 2 Step 5. Try to improve this layout by trial and error to establish a reasonable good arrangement. Switch departments 1-2 as there is a heavy traffic between dept. 1-3. Cost = 480 €. room1 room2 room3 Department 2 Department 1 Department 3 Department 4 Department 5 Department 6 room4 room5 room6

33. Distance and cost-based method : example 2 Step 6. Prepare a detailed place considering space or size requirements of each department; that is, arrange the departments to fit the shape of the building and obstables.

34. Mathematical model for identical dept. Problem: Locate N department on N locations in order to minimize total traffic cost. Decision variable : Xij = 1 if dept. i is located at location j Minimize TC = iji’j’ Djj’ Wii’ Cij Xij Xi’j’ where j Xij = i Xij =1 W : traffic matrix, D : distance matrix C : unit traffic cost Linear Programming model can be developped for the case of rectangular departments of different sizes.

35. Mathematical model for identical dept. Problem: Locate N department on N locations in order to minimize total traffic cost. Decision variable : Xij = 1 if dept. i is located at location j Minimize TC = iji’j’ Djj’ Wii’ Cij Xij Xi’j’ where j Xij = i Xij =1 W : traffic matrix, D : distance matrix C : unit traffic cost Linear Programming model can be developped for the case of rectangular departments of different sizes.

36. Chaptre 2. Facility Layout • Introduction • Product layout • Process layout • Fixed position layout

37. Fixed position layout The fixed-position layout consists of the fixed service positions where personnel and materials come together to perform the service. Generally used in industry when the product is either too large or too delicate to more such as airplane assembly. In inpatient hospital rooms (especially in an intensive care unit), the service position is the patien bed. The operating table in an operating room is another example.

38. Fixed position layout Designing a fixed position layout entails positiioning several service positions withing a given area, each of which may require an adjacent but separate support area. Conflicts about space constraints and timing have to be resolved (suspended x-ray machine and overhead lighting)

39. Chaptre 2. Facility Layout • Introduction • Product layout • Process layout • Fixed position layout • Facility layout supplement

40. Fixed position layout Designing a fixed position layout entails positiioning several service positions withing a given area, each of which may require an adjacent but separate support area. Conflicts about space constraints and timing have to be resolved (suspended x-ray machine and overhead lighting)